Bone Plate

ABSTRACT

A bone plate having a first, bone-facing surface and an opposing second surface has an elongate shaft portion and a head portion that is shorter and wider in comparison thereto, with at least one through hole extending through the bone plate from the first surface to the second surface in the shaft portion. The through hole comprises a variable-angle portion with a hole axis configured to receive a threaded head of a locking screw therein at a desired angle within a permitted range of angulation relative to the hole axis. The second surface has at least one depression which extends therein along a portion of the second surface between the side wall and the through hole, the depression extending about a periphery of the through hole.

FIELD OF THE INVENTION

The present invention relates to the field of surgical devices.Specifically, the invention relates to a bone plate for fixing bonesegments, in particular, the proximal femur of a patient.

BACKGROUND

For stabilizing and fixing fractures it is known to employ bone platesfixed on the bone by means of suitable fastening elements such as, forexample, bone screws, along with pins, bolts or other bone anchors. Toguarantee secure fixation of the bone fragments to each other and of thebone plate to the bone, the bone anchors must be incorporated into thebone precisely. In particular, the angles at which the bone anchors aredriven into the bone are of great importance.

Hence, it is known, for example, from EP 1 741 397 A1 to provide boneplates with through holes having a variable-angle portion which allows athreaded head of a locking screw to be received and locked in a threadedbone plate hole at different angles relative to a hole axis of thethreaded bone plate hole. The threaded bone plate hole may have rib-likeor thread structures interrupted by recesses that extend radially awayfrom the hole axis, whereby one or a plurality of the recesses extendsin the direction of a longitudinally running side edge of the boneplate. However, a problem arises here that, in particular in the regionof the recesses of the variable-angle through hole that extend in thedirection toward the side edge, stress peaks may occur when a bendingload is placed on the bone plate. Because a bone plate is usuallyattached to the side of the bone that is under stress, the stress peaksoccur in particular on the plate's upper side, i.e., the surface of thebone plate that faces away from the bone, when the bone plate is mountedto the bone.

The object of the present invention is to provide a bone plate having avariable-angle through hole wherein stress peaks that occur in theregion of the variable-angle through hole upon a bending load on thebone plate are reduced.

SUMMARY OF THE INVENTION

According to a first aspect of the invention, a bone plate has a firstsurface which, when the bone plate is positioned over the bone, facesthe bone, and a second surface on a side of the bone plate opposing thefirst surface which, when the bone plate is positioned over the bone,faces away from the bone. The bone plate also comprises an elongateshaft portion having two longitudinally running lateral side wallsextending between the first and second surfaces to connect longitudinaledges of the first and second surfaces. In the shaft portion at leastone through hole extends through the bone plate from the first to thesecond surface. The through hole has a variable-angle portion with ahole axis and an inner surface with a rib-like structure. The rib-likestructure is interrupted by recesses extending radially away from thehole axis, at least one of the recesses extending in the direction ofone of the side walls. The rib-like structure can comprise a thread,threaded portions or a thread-like structure or ribs, grooves or thelike which extend in planes perpendicular to the hole axis. The throughhole is configured to receive a threaded head of a head locking screw inthe rib-like structure interrupted by the recesses, at different anglesto the hole axis, so that the head locking screw is preferably lockableat a desired angle relative to the hole axis.

The second, i.e. non-bone-facing, surface of the bone plate may have atleast one depression which extends into a portion of the second surfacebetween the side walls and the through hole, and spaced apart from oneof the side walls. The depression and the at least one through-holerecess extending in the direction of the side wall overlap. In otherwords, the depression extends through a portion of the second surface atleast partially surrounding the through hole. In one exemplaryembodiment, the depression overlaps the through hole completely. Furtherpreferably, the at least one depression is spaced from both side walls.

According to one exemplary embodiment, the depression, in particularwhen it overlaps the through hole completely, has a greater extension ina transverse direction of the bone plate than the through hole. Thus,the portions of the bone plate with a greater risk of breakage such as,for example, portions between a longitudinal edge of the plate and thethrough hole, can be lowered completely with regard to the secondsurface of the bone plate.

In an exemplary embodiment, the depression possesses a substantiallyrectangular shape in a plan view of the second surface of the boneplate. It will be appreciated that the corners of the depression can berounded, the sides can be slightly curved, and opposing sides of thedepression need not be completely parallel in plan view.

According to one exemplary embodiment, a bottom portion of thedepression (e.g., a portion of the depression defining a depth of thedepression) is planar. An edge portion of the depression may have aninclined or preferably curved cross-sectional profile. In particular,the edge portion of the depression may have a cross-sectional profile ina transverse direction of the bone plate that is more strongly inclinedor curved than a cross-sectional profile of the edge portion in alongitudinal direction of the bone plate. Preferably, the inclined orcurved edge portion of the depression and the through-hole recess extendin the direction of the side edge overlap

According to one exemplary embodiment, the edge portion and the bottomportion pass into each other continuously at least in the region of therecess extending in the direction of the side edge. Such a continuoustransition means that the depression has no edge. The transition issmooth and does not form a sharp bend in the depression. Stress peaksare thereby reduced compared with an angular transition.

A depth of the depression is chosen in dependence on the geometry of thebone plate preferably such that the distribution of the stress when abending load is imposed on the bone plate is optimal, in particular soas to weaken stress peaks that occur. It will be appreciated that thedepth of the depression is preferably chosen only up to a measure atwhich the weakening of the bone plate by the depression does notoutweigh the advantage of the improved stress distribution.

According to another exemplary embodiment, the bone plate possesses ahead portion which is shorter and wider than the shaft portion. This canbe, for example, a bone plate for the femur or tibia or other loadhearing long bone. Preferably, there are provided in the shaft portionat least three of the stated through holes with a variable-angleportion, with three of the through holes that are arranged closest tothe head portion respectively overlapping one of the above-describeddepressions on the second surface of the bone plate. However, it will beappreciated that, depending on the case of application, only one or two,more than three, or all, of the through holes can also respectivelyoverlap with a depression.

BRIEF DESCRIPTION OF THE DRAWINGS

The preceding summary of the invention as well as the followingdescription of an exemplary embodiment will become more easilyunderstandable in the light of the attached drawings. An exemplaryembodiment of the invention will be described hereinafter with referenceto the accompanying drawings. It will be appreciated, however, that theapplication is not limited to the exemplary embodiment shown.

FIG. 1 shows a top plan view of a bone plate, according to an exemplaryembodiment of the present invention;

FIG. 2 shows a side view of the bone plate of FIG. 1;

FIG. 3 shows a bottom plan view of the bone plate of FIG. 1;

FIG. 4 shows a perspective view of a portion of the bone plate of FIG.1;

FIG. 5 shows a perspective view of a portion of the bone plate of FIG.1;

FIG. 6 shows an enlarged detailed view of the bone plate of FIG. 1,

FIG. 7 shows an enlarged detailed view of the bone plate of FIG. 3,

FIG. 8 shows a top plan view of a through hole extending through thebone plate of FIG. 1;

FIG. 9 shows a side view of the bone plate of FIG. 1, in the region ofthe through hole;

FIG. 10 shows a cross-sectional view of the bone plate of FIG. 1 alongthe line A-A in FIG. 6;

FIG. 11 shows a cross-sectional view of the bone plate of FIG. 1 alongthe line B-B in FIG. 6;

FIG. 12 shows a side view of a portion of the bone plate of FIG. 1;

FIG. 13 shows a cross-sectional view of the shaft portion of the boneplate of FIG. 1, along the line C-C in FIG. 7; and

FIG. 14 shows a side view of the bone plate of FIG. 1, rotated by 10°.

DETAILED DESCRIPTION

The present invention may be further understood with reference to thefollowing description and the appended drawings, wherein like elementsare referred to with the same reference numerals. Exemplary embodimentsof the present invention describe a bone plate for fixing fractures. Inparticular, the exemplary embodiments describes a bone plate including adepression extending through the bone plate and surrounding a throughhole extending therethrough to reduce stress peaks, for example, along aportion of the between a through hole and a lateral side wall of thebone plate. Although the exemplary embodiments specifically describe abone plate configured for the fixation of a proximal femur, it will beunderstood by those of skill in the art that the bone plate of thepresent invention may be adapted for the fixation of any of a variety ofbones and, in particular, load bearing long bones.

FIG. 1 shows an exemplary embodiment of a bone plate 1 in plan view froman upper side—i.e., a first surface 3 of the bone plate 1 which, whenthe bone plate is implanted or positioned over a bone, faces away fromthe bone. The represented bone plate 1 is dimensioned for treatingfractures of the left proximal femur, for example, of a human patient.It will be appreciated that the concepts described hereinafter are alsoapplicable to other bone plates, in particular to a bone plate for theright proximal femur, the distal femur, or for other long bones, suchas, for example, the tibia. In FIG. 2, the bone plate 1 is representedin a side view. FIG. 3 shows the bone plate 1 from an underside of theplate, i.e., from a second surface 2 which, when the bone plate isimplanted or positioned over a bone, faces the bone.

The bone plate 1 comprises an elongate shaft portion 4 and a headportion 5 along with lateral side walls 6, 7 extending along the shaftportion 4 between the surfaces 2, 3 to define a width of the shaftportion 4. The width of the shaft portion 4 is substantially constantover a total length of the shaft portion 4. The head portion 5 is widerthan the shaft portion 4, i.e., a distance between the surfaces 2, 3 islarger at the head portion 5 than at the shaft portion 4, and shorterthan the shaft portion 4, i.e., a length of the head portion 5 along alongitudinal axis of the bone plate 1 is smaller than a length of theshaft portion 4 along the longitudinal axis of the bone plate. In oneexemplary embodiment, the head portion 5 is preferably configured toadjoin the proximal femur, in particular, the greater trochanter. Forexample, the head portion 5 may have a curvature corresponding to thegreater trochanter, as seen especially well in FIG. 2. The head portion5 has a plurality of through holes 9, which may be formed here asvariable-angle through holes and/or fixed angle through holes. In oneexemplary embodiment, the head portion 5 may include, for example, seventhrough holes 9, three of which may be fixed angle through holes and theremaining through holes formed as variable angle through holes. It willbe understood by those of skill in the art, however, that the pluralityof through holes 9 may include any combination of variable angle andfixed angled through holes. The head portion 5 is also represented inFIGS. 4 and 5. FIG. 4 shows the head portion 5 in a perspective viewfrom the first surface 3 of the bone plate 1, whereas FIG. 5 shows thehead portion 5 of the bone plate 1 in a perspective view from the secondsurface 2 of the bone plate 1. The shaft portion 4 has an elongate shapeand may include a slight curvature to correspond to the shape of thefemur. It will be understood by those of skill in the art that a boneplate configured for the right proximal femur may have an accordinglyopposite curvature.

As represented in detail in FIG. 8, the through holes 8 in the shaftportion 4 are formed as combination holes. The through holes 8 have avariable-angle portion 15 as well as a compression hole 18. Thevariable-angle portion 15 possesses a rib- or thread-like structure 17along an inner surface thereof, which tapers in a direction extendingtoward the bone-facing surface 2. The thread-like structure 17 isinterrupted by recesses 16, which extend from the hole axis 19 radiallyoutward. In the exemplary embodiment shown, there are formed four“columns” of the rib- or thread-like structure 17 which are separatedfrom one another by the recesses 16. It will he understood by those ofskill in the art, however, that the variable-angle portion 15 is notrequired to include four columns and may include, for example, 2 or morecolumns. As is known to the person skilled in the art, thevariable-angle portion 15 is configured to receive a head locking screwwhich is introducible with its head thread into the variable-angleportion 15 of the through hole 8 at different angles, and lockable sothat the screw is locked therewithin at a desired angle relative to thehole axis. The compression hole 18 has an unthreaded, i.e. smooth, innersurface 23 tapering in the direction of the bone-facing surface 2. Thecompression hole 18 is moreover elongated in the longitudinal directionof the shaft portion 4, so that the introduction of a compression screwwith a smooth screw head therein causes a compression of the subjacentbone segments, as is known to the person skilled in the art.

Although the through hole 8 is described and shown as a combination holeincluding a variable angle 15 and compression hole portion 18, it willbe understood by those of skill in the art that the through hole 18 mayinclude other configurations. For example, the through hole 8 mayinclude a locking hole portion and a compression hole portion open toone another. The locking hole portion may include, for example, athreading extending thereabout configured to lockingly receive athreaded head of a locking screw. The compression hole portion may besubstantially similar to the compression hole portion 18 describedabove, including an unthreaded tapered surface for interfacing with asmooth head of a compression screw.

As is represented in FIG. 1, the first three through holes 8 along theshaft 4 that are closest in distance to the head portion 5, respectivelyoverlap a depression 10 on the surface 3 of the plate's upper side. Inother words, the depression 10 may extend through a portion of the boneplate 1 surrounding, or at least partially surrounding, the through hole8. Although the exemplary embodiment specifically shows and describesthree through holes 8 as including a depression 10 extending thereabout,it will be understood by those of skill in the art that any number ofthe through holes 8 may include a depression 10 extending thereabout.Furthermore, there is provided on the plate's upper side in the surface3 a cavity 11 between the first through hole 8—i.e., the through hole 8closest in distance to the head portion 5—and the head portion 5. On thesecond surface 2 there are arranged, as represented in FIG. 3, groups ofrecesses 12 along the length of the shaft portion 4. The depressions 10and the cavity 11 are likewise represented in FIGS. 4 and 6. Therecesses 12 are seen in detail in FIGS. 5 and 7. The depressions 10, thecavity 11 and the recesses 12 contribute both individually and incombination to reducing the risk of breakage of the bone plate 1, asdescribed in detail hereinafter. Hence, it will be appreciated that thedepressions 10, the cavity 11 and the recesses 12 can be provided in abone plate separately or together.

FIG. 8 shows the depression 10 in plan view of the plate's first surface3. The depression 10 may have a substantially rectangular shape andcompletely overlaps the through hole 8 formed as a combination hole. Inparticular in the region of the recesses 16 of the variable-angleportion 15 of the through hole 8, which point in the direction of thelateral side walls 6, 7 of the shaft portion 4 of the bone plate 1, theprovision of the depression 10 can reduce stress peaks that occur when abending load or torsional load is imposed on the bone plate 1. The mouthof the through hole 8 is brought closer to a center plane of the boneplate 1 by the depression 10. The depression 10 can be produced, forexample, by milling the surface 3 of the bone plate 1. The depression 10has edge regions 13 which, in the represented embodiment, overlap withthe recesses 16 which point in the direction of the side walls 6, 7. InFIG. 9 the depression 10 is represented in a side view of the bone plate1. A bottom portion 14 (e.g., a portion defining a depth of thedepression 10) is indicated by dashed lines. The bottom portion 14 maybe substantially planar, whereas edge regions 13 may be curved. The edgeregions 13 pass into the bottom region 14 smoothly. FIG. 10 shows across-section of the through hole 8 and the depression 10 in a sectionalong the line A-A in FIG. 6. FIG. 10 also shows the variable-angleportion 15 which overlaps with the compression hole 18.

In FIG. 11 shows a cross-section of the bone plate 1 along the line B-Bin FIG. 6. The sectional representation shows the first through hole 8,closest in distance to the head portion 5, which overlaps with thedepression 10. As also represented in FIG. 6, the cavity 11 borders withits distal end 21 on the depression 10 of the first through hole 8. Thedepression 10 and the cavity 11 are open to one another at the end 21 ofthe cavity 11. The depression 10 and the cavity 11 may have the samewidth, in particular, at the place where they border on each other. Thisenables the cavity 11 and the depression 10 to be produced, for examplemilled, in one step. The cavity 11 serves to increase the flexibility ofthe region between the first through hole 8 and the head portion 5 ofthe bone plate 1, so as to reduce the risk of breakage of the bone platein the region of the first through hole 8. In particular, the bonefracture can lie in the region of the bone plate 1 that lies between thefirst through hole 8 and the head portion 5, so that an especially highload acts on the bone plate 1 here.

As represented in FIG. 11, the cavity 11 has a curved cross-sectionalprofile. The depth of the cavity 11 increases continuously from theshaft portion 4 in the direction of the head portion 5 from the distalend 21 of the cavity 11 to a deepest point 20. In an exemplaryembodiment, the depth of the cavity 11 decreases continuously from thedeepest point 20 to a proximal end 22, with the cavity 11 tapering offrelatively flat, that is to say, enclosing an angle, which in oneembodiment, is smaller than 10° relative to the first surface 3 of thebone plate 1. As seen in FIGS. 4 and 6, the cavity 11 does not extendover the total width of the shaft portion 4 of the bone plate 1 (i.e., adistance between the lateral side walls 6, 7 of the bone plate), but isspaced from the side walls 6, 7. This retains a sufficient stability ofthe bone plate 1 in spite of the elevated flexibility caused by thecavity 11.

In FIG. 12 there is represented a side view of the bone plate 1, inparticular of the shaft portion 4, in which a group G of recesses 12 isto be seen. For the sake of better representability, FIG. 14 shows theshaft portion 4 in a view rotated by 10° about the longitudinal axis ofthe bone plate 1. FIG. 13 shows a cross-sectional view of the shaftportion 4 of the bone plate 1 along the line C-C in FIG. 7. As seen inFIGS. 7, 12 and 13, a group G of recesses 12 which is associated withone of the through holes 8 comprises four recesses 12′, 12″, 12″′, 12″″,whereby in this embodiment not only a plurality, but all groups G havethe identical four recesses 12′, 12″, 12″′, 12″″ (except the first andthe last group). In one exemplary embodiment, the first recess 12′ andthird recess 12″′ are formed substantially identically, the secondrecess 12″ being formed smaller. The fourth recess 12″ connects thesecond and the third recess 12″, 12″′, so that these can alternativelyalso be regarded as a contiguous recess. As seen in FIG. 14, therecesses 12 extend from one of the side walls 6, 7 obliquely toward thecenter of the bone plate 1, having the greatest depth on the side wall6, 7 of the bone plate 1. As seen in particular in FIG. 7, the groups Gof recesses 12 are arranged alternately offset from each other on theopposing side walls 6, 7 of the shaft portion 4 of the bone plate 1 andin the direction of longitudinal extension of the shaft portion 4, withthe opposing groups G of recesses 12 partly overlapping in the directionof longitudinal extension of the shaft portion 4. The arrangement of thegroups G of recesses 12 corresponds to the arrangement of the throughholes 8 along the longitudinal extension of the shaft portion 4. As seenin FIG. 7, the through holes 8 are arranged offset from each otheralternately with respect to a center axis extending in the direction oflongitudinal extension of the shaft portion 4. Accordingly, the groups Gof recesses 12 are also arranged offset from each other alternately withregard to the center axis. Preferably, the cross-sectional area canrespectively be formed along the longitudinal extension of the shaftportion 4 such that the section modulus of the shaft portion 4 issubstantially constant along its longitudinal extension, but at leastuniform, i.e. not subject to any great fluctuations. This avoids thehighest stress upon a bending of the bone plate 1 occurring at a throughhole 8. As seen in FIGS. 5 and 7, it will be appreciated that althoughthe groups G of recesses 12 are preferably identical along thelongitudinal extension of the shaft portion 4, the recesses 12associated with the first through hole 8 (i.e., the through hole closestto the head portion 5) and the last through hole 8 (i.e., the throughhole furthest from the head portion 5) are associated with a group G ofrecesses 12 which may not include all of the recesses 12′, 12″, 12″′ and12″″ described above, because the respective end of the shaft portion 4is reached.

Although the preferred embodiment was described with reference to a leftor right proximal femur, it will be appreciated that the principle ofthe invention can also be applied to bone plates for other bones. Forexample, the invention can also be employed for the distal femur, thetibia or other load bearing long bones. It will be appreciated that theshape and dimensioning of the bone plate can be adapted in accordancewith the case of application without impairing the principle of theinvention.

It will be apparent to those skilled in the art that variousmodifications and variations may be made in the structure and themethodology of the present invention, without departing from the spiritor scope of the invention. Thus, it is intended that the presentinvention cover modifications and variations of the invention providedthat they come within the scope of the appended claims and theirequivalents.

1-16. (canceled)
 17. A bone plate, comprising: a plate body a plate bodyhaving a first, bone-facing surface and a second surface opposing thefirst surface, longitudinal edges of the first and second surfacesconnected to one another via lateral side walls, the plate bodyincluding an elongate shaft portion and a head portion extending from anend thereof; a plurality of through holes extending through the elongateshaft from the first surface to the second surface, each of the throughholes configured to receive a bone fixation element therein; adepression extending into the second surface about at least a portion ofa periphery of a first one of the through holes; and a plurality ofrecesses extending into the first surface from a side wall obliquelytoward the through hole, the recesses being arranged in groups, eachgroup corresponding to a respective one of the through holes andincluding at least two of the recesses, each of the groups beingpositioned along one lateral side of the corresponding through hole. 18.The bone plate of claim 17, wherein at least a first one of the groupsof recesses includes first, second, third and fourth recesses, thesecond recess being smaller than the first and third recesses and beingpositioned therebetween, the fourth recess connecting the second andthird recesses to one another.
 19. The bone plate of claim 17, whereinthe through holes are arranged offset from one another alternately alonga central longitudinal axis of the plate body.
 20. The bone plate ofclaim 19, wherein the groups of recesses are arranged to alternatelyextend from opposing lateral side walls.
 21. The bone plate of claim 17,wherein the recesses extend into the first surface at a maximum depth atthe side wall.
 22. The bone plate of claim 17, wherein the depressionextends about an entire periphery of the first through hole.
 23. Thebone plate of claim 17, wherein groups of recesses associated withadjacent through holes partly overlap one another along a length of theshaft.
 24. A bone plate, comprising: a plate body a plate body having afirst, bone-facing surface and a second surface opposing the firstsurface, longitudinal edges of the first and second surfaces connectedto one another via lateral side walls, the plate body including anelongate shaft portion and a head portion extending from an end thereof;a plurality of through holes extending through the elongate shaft fromthe first surface to the second surface, each of the through holesconfigured to receive a bone fixation element therein; a depressionextending into the second surface about at least a portion of aperiphery of a first one of the through holes; and a plurality ofrecesses extending into the first surface from a side wall obliquelytoward a central longitudinal axis of the plate, the recesses beingarranged in groups, each group corresponding to a respective one of thethrough holes and including at least two of the recesses, each of thegroups being positioned along one lateral side of the correspondingthrough hole. wherein the depression is defined by a bottom portion andan edge portion, and wherein the edge portion of the depression and atleast one of recesses of the group of recesses corresponding to thefirst through hole overlap.
 25. The bone plate of claim 24, wherein theedge portion has a curved cross-sectional profile.
 26. The bone plate ofclaim 24, wherein the bottom portion is substantially planar.
 27. Thebone plate of claim 24, wherein the edge portion and the bottom portionare connected to define a smooth surface of the depression.
 28. The boneplate of claim 24, wherein a first one of the groups of recessesincludes first, second, third and fourth recesses, the second recessbeing smaller than the first and third recesses and being positionedtherebetween, the fourth recess connecting the second and thirdrecesses.
 29. The bone plate of claim 24, wherein the through holes arearranged offset from one another alternately with respect to the centrallongitudinal axis.
 30. The bone plate of claim 29, wherein the groups ofrecesses are arranged to alternately extend toward the correspondingthrough holes from opposing lateral side walls.
 31. The bone plate ofclaim 24, wherein the recesses extend into the first surface to amaximum depth at the side wall.
 32. The bone plate of claim 24, whereinthe depression extends about an entire periphery of the first throughhole.
 33. The bone plate of claim 24, wherein groups of recessesassociated with adjacent through holes partly overlap one another alonga the central longitudinal axis.
 34. The bone plate of claim 24, whereinthe first through holes further comprises a variable angle portionoverlapping with the compression hole portion, the variable angleportion being configured to receive a threaded head of a locking screwat a desired angle within a permitted range of angulation relative to ahole axis.
 35. The bone plate of claim 34, wherein the variable angleportion includes an engaging structure for engaging the threaded head ofthe locking screw, the engaging structure being interrupted by aplurality of radially extending recesses.
 36. The bone plate of claim35, wherein the first through hole further comprises a locking holeportion including a threading extending thereabout to lockingly receivea correspondingly threaded head of a locking screw.